GOVERNMENT GAZETTE NO = 22296

DATE =2001-05-16

GOVERNMENT NOTICE NO = 422

ORGANISATION =DEPARTMENT OF LABOUR

TITLE =COMPENSATION BOARD: CIRCULAR INSTRUCTION 171

ACT =COMPENSATION FOR OCCUPATIONAL INJURIES AND DISEASES ACT,

1993 (ACT 130 OF 1993)

DEPARTMENT OF LABOUR

COMPENSATION BOARD

16 MAY 2001

GOVERNMENT NOTICE 422 OF 2001

COMPENSATION FOR OCCUPATIONAL INJURIES

AND DISEASES ACT, 1993

(ACT 130 OF 1993)

DATE OF COMMENCEMENT 16 MAY 2001

DEPARTMENT OF LABOUR

COMPENSATION BOARD

16 MAY 2001

GOVERNMENT NOTICE 422 OF 2001

COMPENSATION FOR OCCUPATIONAL INJURIES

AND DISEASES ACT, 1993

(ACT 130 OF 1993)

DATE OF COMMENCEMENT 16 MAY 2001

CIRCULAR INSTRUCTION 171

THE DETERMINATION OF PERMANENT DISABLEMENT RESULTING FROM

HEARING LOSS CAUSED BY EXPOSURE TO EXCESSIVE NOISE AND TRAUMA

The following instructions are issued to clarify the position in regard to claims for impairment of hearing:

1 HEARING IMPAIRMENT

1.1 An occupational disease due to excessive noise in industry; and

1.2 An occupational injury due to factors other than excessive industrial noise
[head trauma (resulting from e.g. blows to the head), or acoustic trauma causing
the immediate loss of hearing produced by one or more exposures to sudden
intense forms of acoustic energy such as explosions, gunfire or blasts].

Such "accidents" may cause binaural (both ears) or monaural (one ear) impairment
of hearing.

1.3 In loss of hearing "by accident" in either one or in both ears the impairment
may be caused by either conductive loss when the middle ear is injured or by
perceptive loss when the inner ear is injured or by a combination of both conductive
and perceptive loss when both the middle and the inner ear are injured - the so-called
"mixed deafness".

1.4 Impairment of hearing claimed to result from exposure to excessive noise in
industry (occupational noise of an excessive nature) usually manifests itself over
a number of years and results in binaural impairment of hearing.

1.5 The provisions of Section 65.4 of the Act referring to prescription shall
be strictly applied with due regard to the provisions of Section 38 of the Act.

1.6 The date of the commencement of the disease shall be the date of the first
audiogram showing an increase from the baseline in the percentage loss of
hearing (PLH) by 10% or more. The PLH values are calculated using the results
of the baseline audiogram and the diagnostic audiogram using the attached tables.

ANNEXURE A

1.7 Persons to be submitted for compensation consideration would be:

-Employees whose PLH has deteriorated by more than 10% PLH from the
baseline audiogram; or

-Employees who have more than 10% PLH and for whom no baseline is
available (see section 5).

1.8 A medical opinion must be provided by either:

1.8.1 An ENT-specialist if the case is complicated or the degree of disablement
is expected to exceed 15% (PLH (see image) 30 % from baseline);

1.8.2 An Occupational Medical Practitioner if the case is uncomplicated and the
degree of disablement is expected to be 15% or less (PLH 30% from baseline).

2 BINAURAL HEARING IMPAIRMENT

2.1 In cases where binaural hearing impairment is claimed as a result of
mechanical or acoustic trauma, the principles as laid down under paragraph
1.4, 1.5 and 1.6 for occupational hearing loss due to excessive noise in
industry apply, with the exception that the ENT-Surgeon/Occupational
Medical practitioner should certify that the impairment found on examination
is compatible with the nature of the injury sustained or is due to acoustic
trauma of the nature and intensity experienced by the employee and that
no other cause(s) for the impairment of hearing were found on examination.

3 MONAURAL HEARING- IMPAIRMENT

3.1 Noise-induced hearing loss affects both ears to more or less an equal degree
and the impairment is due to a perceptive loss. If, therefore, the loss of hearing
is monaural, it must be assessed whether the loss is commensurate with noise
exposure to one ear more than the other such as gun shots in security workers.
The assessment of permanent disablement for the loss of hearing in one or both
ears as detailed takes cognisance of such additional factors as tinnitus,
unhealed perforations of the tympanic membranes with possible recrudescence
of infections following thereon and/or mastoidectomies. In the event of recurring
infections in the two latter instances, medical treatment should be provided and
the employee should receive periodical payments.

4 DOCUMENTATION TO ACCOMPANY A CLAIM FOR COMPENSATION

Claims will be submitted either to the Compensation Commissioner or to the
Mutual Association as applicable. Over and above the standard
documentation required i.e. Employer's Report of an Occupational Disease/injury
(W C1.1/2) and Notice of an Occupational Disease/Injury and Claim for
Compensation(W C1.14/3), the following documents are required:

4.1 Claimant's service record - this should confirm in writing exposure to
excessive occupational noise. The intensity and duration of exposure should
be commensurate with the hearing impairment.

4.2 It should be proved that the noise was of such a nature and intensity and
exposure to it of such duration, as to be likely to have caused permanent
noise-induced hearing impairment. The compensability of a claim can only be
considered where noise level readings exceed the maximum laid down by
the South African Bureau of Standards (S.A.B.S. 083-1483) and which is known
as the N85 Noise Rating Curve Level.

4.3 Medical opinion - this should state that the hearing loss is compatible with
noise induced hearing impairment. In atypical cases an appropriate explanation
should be provided.

4.4 Audiograms - two audiograms conducted by the diagnostic audiologist should
be submitted. The audiograms should be performed after at least 24 hours
have elapsed from the last exposure to excessive noise. The audiograms may be
done on the same day but at different sittings. The audiograms must not differ
by more than 10 dB at any frequency. The better diagnostic audiogram will be used
to calculate PLH for compensation purposes.

If required, a third audiogram shall be performed. If this is still not
within the 10dB limit then the assessment shall be delayed for a period of 6 months.
If audiograms of the required quality are still not obtained after 6 months then
referral to an ENT-specialist will be made in order to determine hearing loss.

4.5 A copy of the baseline audiogram (and calculated PLH). This is important
as the baseline PLH will be subtracted from the better diagnostic audiogram
PLH to determine the hearing loss for which the Commissioner, Mutual Association
or Employer Individually Liable, is responsible.

4.6 Proof of employee's identity - the audiologist performing the audiogram
should attest in writing to the employee's identity.

5 CALCULATION OF PERMANENT DISABLEMENT

5.1 The better of the two diagnostic audiograms will be used: Ensure that all
documentation (4) is present and correct.

5.2 Calculate (from PLH tables - Annexure A) a PLH for each of the following
frequencies: 500, 1000, 2000, 3000 and 4000 Hz (Air conduction results to be
taken except if specified otherwise by the medical officer).

5.3 Sum the values for each frequency to obtain the PLH.

5.4 If a baseline PLH is available this value is subtracted from the PLH
obtained from 5.3.

5.5 If a baseline PLH is unavailable the PLH in 5.3 is taken as the value from
which permanent disability will be calculated.

5.6 Permanent Disablement is calculated by halving the value of the PLH obtained
in either: 5.4 (if a baseline PLH is available) or 5.5 (if a baseline PLH is unavailable).

ANNEXURE B